Does anyone know what 'i' before '-caine' means when talking about a novocain allergy?

A patient has had allergy to Novocain and the nurse asks if they should have done a skin test prior to surgery to see what other local anesthetics she was allergic too. The doctor mumbled anything with an "i" before caine??? Does that mean it's safe or not? And what drugs have an "i" before caine because I only located one.

Answers (2)

I used to work in ambulatory surgery and I cant tell you how many times people would come in claiming to be "allergic" to "caines". Our anesthesiologist, who was a spry older gent in his early 70's with a lifetime experience with anesthesia (Gosh I learned so much from him!) told me that a true allergy to "caines" is very rare and on further questioning almost all of these folks claimed to have a reaction at the dentist. Dentists use local anesthetic that has epinepherine (or adrenaline) added because this helps to control bleeding because the mouth is a vascular area-epi constricts blood vessels so bleeding is contained. These folks state their reaction was rapid heart rate, rapid gasping breathing or difficulty getting their breath, jittery feelings, shakiness, nausea etc. There was no swelling, no closing up of the throat, swelling of the tongue or any true signs of anaphylactic reaction.

The reactions they describe is a reaction to the epi NOT the "caine" Epinepherine (otherwise called adrenaline) will cause rapid heart rate, rapid breathing (which some misinterpret as gasping or difficulty catching their breath), nausea, dizziness etc. It is the "fight or flight" hormone the body releases under great fear or stress and everyone knows how the body feels when you have had a fright-your heart pounds, you can feel out of breath, dizzy, shaky, nauseated etc. This is adrenaline and some people are sensitive to it. Sure as you-know-what, we would do their local block with marcaine/lidocaine and they would have no problems what so ever. Always, when someone says they have an "allergy" find out the circumstances of the event and what kind of reaction they had. Many people do not know what a true "allergy" reaction is. I would suspect that most likely the Dr mumbles something to this effect-allergies to "caines" are rare! If the event happened in the dentists office and the reaction was normal reaction to epinepherine then you dont need to worry-let the anesthesiologist know the findings and I would bet the patient will do fine with a local sans epi.